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How to eat after your procedure

Adopting new eating habits after your 
endoscopic weight loss procedure is one of the most important steps for safe recovery and long-term success. 

Eating after your endoscopic weight loss procedure

After having Endoscopic Sleeve Gastroplasty (ESG), Intragastric Balloon (IGB) placement or removal, or Transoral Outlet Reduction (TORe), your diet will move through stages as your stomach heals and adapts. Each stage is designed to protect your body, minimise discomfort, and help you learn new ways of eating. The right approach to food will not only help your body heal but also support a healthier relationship with eating.

Note: Your healthcare team will provide you with detailed, specific dietary guidance to follow. The information below is to give you an idea of what you might expect. Always follow your healthcare provider's instructions.

Stage 1: Clear liquids (days 1-2)

  • Start with small sips of water, clear broths, and sugar-free, non-carbonated drinks.1,2 
  • Drink slowly _ around 200ml per hour to start. 
  • Aim to drink 1.5-2.5 litres of fluid daily to stay hydrated and reduce the risk of nausea.3,4

Stage 2: Full liquids (days 3–7)

  • Gradually add low-sugar, high-protein drinks like protein shakes, skimmed milk, low-fat soup, sugar-free yogurt drinks, or smooth, blended meals.1,3 
  • Aim for 15-20g protein per serving.5

Stage 3: Pureed and soft foods (weeks 2-3)

  • In this stage, you can start pureed or soft foods, but take it slowly. 2,3 
  • Soft, easy-to-digest foods include blended soups, pureed fruit and vegetables, fat-free yogurt, and eggs.6 
  • Eat 4-6 small meals daily, focusing on portion size and fullness cues.3 
  • Aim for 60-80g of protein and 800-1000 calories per day.5,6

Stage 4: Solid foods (week 4 onwards)

  • Gradually reintroduce regular textured food, such as lean proteins, cooked vegetables, and soft fruits. 
  • Chew thoroughly, eat slowly, and stop at the first sign of fullness. 
  • If you've had an IGB placed, you should take extra care with bread, pasta, or sticky foods, which some people feel get 'stuck' and make them feel sick.4 
  • Continue to avoid high calorie/high sugar drinks.1 

Steps for long-term success

The way you approach food and eating after your endoscopic weight loss procedure will change. Embracing a few key principles will help you stick to a healthy diet long-term. 

Focus on protein

Protein is key to your body's recovery and function, and helps you feel satisfied for longer.6 Aim to include 2-3 portions of protein each day (a portion is about 60-90g / 2-3oz). Good options include lean meats, fish, eggs, dairy, beans, or meat alternatives. 

Make protein the foundation of your meals. Try to fill at least half your plate with protein rich foods, and eat this part of your meal first.7

The 20-20-20 rule

Follow the  '20-20-20'  approach: take bites the size of a 20p coin, chew each bite 20 times, and if you're still eating at the 20-minute mark, pause to assess if you're actually still hungry.7 

Pay attention to hunger and fullness signals; this is key to lasting success.

Stay hydrated

It's very important to stay hydrated. As your stomach has less space, you need to drink small amounts
frequently. Aim for 1.5-2 litres of water a day in small sips, and avoid drinking large amounts at once.4 

Tips for staying hydrated: 

  • Avoid using straws, as they can increase air swallowing and cause discomfort. 
  • Separate your meals and liquids by not drinking 30 minutes before and after eating. This prevents you from filling your stomach with liquids instead of nutrients and keeps your food from being 'flushed' through your system too quickly after eating.7,8 

Small portions and limited snacks

Keep your meals small. A good tip is to use a side plate or tea plate for your meals instead of a regular dinner plate, as this will help you keep your portion sizes small.1

Be careful to avoid snacking or grazing throughout the day, particularly on unhealthy snacks.1 Sticking to planned meals helps you retrain your hunger and fullness cues.

Supplements

Your doctor will advise if you need to take any vitamin and mineral supplements. 

Get active

Physical activity supports recovery, helps maintain weight loss, and improves overall wellbeing. Start gently and follow your doctor's advice, increasing activity as your body heals. Over time, aim for regular movement that raises your heart rate and fits comfortably into your daily routine.9

Looking ahead

After your procedure, success is about more than the food on your plate - it's about building patterns that last. Slowing down, paying attention to portion sizes, and listening to your body's signals can help you create healthier habits that support you for life. 

Nutrition is just one part of a happy, healthy life. Explore more tips on healthy habits to support long-term success after Endoscopic Sleeve 
Gastroplasty, Intragastric Balloon placement, or Transoral Outlet Reduction . 

Ready to find out if an endoscopic weight loss procedure is right for you?

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References

  1. North Tees and Hartlepool NHS Foundation Trust. Dietary advice following Endoscopic Sleeve Gastroplasty (ESG) procedure [Internet]. Stockton-on-Tees: NTH NHS Foundation Trust; 2024. Available from: https://www.nth.nhs.uk/resources/diet-following-esg/ [Accessed 2026 May]. 
  2. Crossan K, Sheer AJ. Intragastric Balloon. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK578184/ [Accessed 2026 May]. 
  3. Calderdale and Huddersfield NHS Foundation Trust. Your Diet Following Gastric Balloon Placement [Internet]. Halifax: CHFT; 2023. Available from: https://plr.cht.nhs.uk/download/1163/Your%20Diet%20following%20Gastric%20Balloon%20Placement%20A4 [Accessed 2026 May]. 
  4. Chelsea and Westminster Hospital NHS Foundation Trust. Dietary Guidance after Intra-gastric Balloon Insertion [Internet]. London: Chelsea and Westminster Hospital NHS Foundation Trust; 2024. Available from: https://www.chelwest.nhs.uk/your-visit/patient-leaflets/bariatric-dietetics/dietary-guidance-after-intra-gastric-balloon-insertion [Accessed 2026 May]. 
  5. Sherf Dagan S, et al. Nutritional recommendations for adult bariatric surgery patients: clinical practice. Adv Nutr. 2017;8(2):382-94. 
  6. Negi A, et al. Nutritional management and role of multidisciplinary follow-up after endoscopic bariatric treatment for obesity. Nutrients. 2022;14(16):3450. 
  7. Royal Berkshire NHS Foundation Trust. Dietary advice following an intragastric balloon [Internet]. Reading: Royal Berkshire NHS Foundation Trust; 2024. Available from: https://www.royalberkshire.nhs.uk/media/gvkcdh1w/dietary-advice-following-an-intragastric-balloon_final_oct24.pdf [Accessed 2026 May]. 
  8. Richardson WS, et al. Long-term management of patients after weight loss surgery. Ochsner J. 2009;9(3):154-9. 
  9. McGrice M, et al. Interventions to improve long-term weight loss in patients following bariatric surgery: challenges and solutions. Diabetes Metab Syndr Obes. 2015;8:263-74. 

 

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